Test 2: Orthopedic Intervention Flashcards
What is the over-arching goal of orthopedic interventions??
To Achieve MAXIMAL function of the body and affected extremities to: restore functional performance
What is the proper ROM sequence?
– PROM -> AAROM -> AROM
What is the goal during the acute phase of orthopedic intervention?
• Relieve pain, decrease swelling and inflammation • Promote wound healing – Wound care • Maintain joint or limb alignment • Restore function to injury location • Modify the activity
What is the goal during the chronic phase of orthopedic intervention?
• Same as above with more emphasis on functional return • Posture education • Body Mechanics • Modify the activity • individualized
Every shoulder intervention should include?
Scapular mobilization
Is there a difference between Passive ROM and Passive stretching?
Yes
True or false, shoulder exercises should be pain-free
True
Increasing shoulder strength and ROM should be done through
Functional Activities
Shoulder intervention progression
Isometrics -> isotonics -> Functional Activities
The Surgical Shoulder common treatment modalities?
• PROM to AAROM exercises • Cold Packs or other modalities • Edema Control • Pulleys • Scapular Mobilization • Joint Mobilization
For a rotator cuff tear, the client will wear an abduction pillow brace for ___ weeks post op
4-6 weeks
Concerns for RTC tear
• Typically will follow a protocol for progression of ROM and degrees allowed • Axilla region hygiene • Codman’s Pendulums
Phase 1 • Joint mobilization
• Phase 2-frozen – Dull ache with active movements, sharp pain at end range (4-12 months)
Freezing
The pain during phase 1 of adhesive capsulitis lasts for how long?
2-9 months
Phase 2 of adhesive capsulitis is the ___ stage
Frozen
Interventions during phase 1 of adhesive capsulitis include?
• Pain free ROM • Pain free stretches • Isometric Strengthening • Activity Modifications • Scapular Mobilization
Interventions during phase 2 of adhesive capsulitis include?
• progressive prolonged stretching • Joint Mobilization • Scapular Mobilization • Shoulder Dynasplint • Strengthening • Activity Modifications
The pain during phase 2 of adhesive capsulitis is ____ in nature with sharp pain at _____ for __ - __ months
Dull, end range, 4-12
• Phase 3 , joint motion and strength returns (6-9 months) •
thawing
Pain ____ during phase 3 of adhesive capsulitis
subsides
During phase 3 of adhesive capsulitis, joint motion and strength returns at around __-__ months
6-9 months
Treatment during phase 3 of adhesive capsulitis
Continue Joint Mobilization • Continue Scapular Mobilization as needed • Progress strengthening and stretching • Restore GH and scapular rhythm • Functional Activities
TENS is a type of electrical stimulation used to treat ____
Adhesive capsulitis
Treatment for adhesive capsulitis
TENS, Heat and ice before and after exercises, deep breathing and relaxation exercises
Total shoulder replacements typically follow a protocol as per ___
physician
___ region hygiene is a big concern for total shoulder replacement clients
axilla
_____ after total shoulder replacement is limited as per physician
Rotation
What tendon is commonly incised after a total shoulder replacement
Subscapularis Tendon
Total shoulder replacement treatment modalities
Scapular Mobilization • Typically in a Sling adducted to side in Internal Rotation • ROM progression as per protocol • Strengthening progression as per protocol • Edema control • Joints Above and Below • Codman’s Pendulum Exercises
Reverse total shoulder gives ____ in early rehab but worse ______ than regular total shoulder.
less difficulty
end ROM
____ is the most common orthopedic elbow problem
Tendonitis/osis
Intervention strategies for elbow pathologies
• Activity Modification • Ice or other modalities • CFM • Flexibility exercises • Ergonomics • Strengthening Progression • Functional Activity training
• Strengthen proximally- shoulders and reinforce good posture
As well as upper and lower arm musculature
Built up handles/utensils are used for what orthopedic issue?
Lateral and Medial Epicondylitis
With medial epicondylitis, the wrist is splinted in ___
Neutral
Treatment for Lateral and Medial Epicondylitis includes ____ strengthening
Proximal
Treatment for Lateral and Medial Epicondylitis includes ____ strengthening
Proximal
Counter-force strap over flexor or extensor muscle bundles are commonly used for
Lateral and Medial Epicondylitis
For UE fracture Interventions treatment can begin ____
as soon as the cast is applied or after reduction
Timing, amount and kind of activity for UE treatment depends on ____
the location and severity of fracture and potential age of client
Activity modification for UE fractures includes doing activities ___
One handed
UE fracture interventions include
• Activity Modification – one handed
• ROM
• Codman’s exercises • Joints above and below
Fracture Interventions • Modalities • Control Edema • Massage • Joint Mobilization • Strengthening • Elbow • Typically splinted in 90 degrees of flexion. Why? • Pronation and supination are emphasized.
For UE elbow fractures the elbow is typically splinted in ___ degrees
90
___ and ___ are emphasized with elbow fractures
Pronation and supination
Most activities are performed between ___ and __⁰ of flexion Shoulder • Reach Perineum – 75-90º Hor Abd, 30-45º abd, 90+º IR • Tuck in Shirt – 50-60º Hor Abd, 55-65º Abd, 90º IR • Put something on a shelf – 70-80º Flex, 45º ER
30 to 130
Most activities are performed at ___ of pronation and supination
50⁰
To reach behind the head ___ of flexion is necessary
140 ⁰
Eating requires ___-___ degrees of shoulder abduction
45-60º
To reach Perineum, __-__Hor Abd is necessary abd, 90+º IR
75-90º
To reach Perineum, __-__ of abduction is necessary
30-45º
To reach Perineum, __ degrees of internal rotation is necessary
90 degrees
